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Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers Erlyn A. Sana, PhD.

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Presentation on theme: "Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers Erlyn A. Sana, PhD."— Presentation transcript:

1 Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers Erlyn A. Sana, PhD

2 The resident’s workplace: the ward

3 The resident’s workplace: the OPD

4 1.Obstetrics Admission Section (OBAS) 2.Consultation Room 3.Labor Room 4.Delivery Room 5.Operating Room 6.Intensive Maternal Unit 1.Conference Rooms 2.Library 3.Lecture Halls 4.Classrooms with peers and/or consultants 5.Call room The Ob-Gyn resident’s workplace

5 The Ob-Gyn resident’s teaching- learning milieu TOs

6 Professional roles & general terminal competencies expected of residents Leadership & Professionalism

7 Those sets of values that sustain the interest of the patient above one’s own self-interest, Entails a wide range of attitudes and behaviours such as altruism, humility, commitment to excellence, duty & commitment to service, honour & respect for others, integrity & compassion, and accountability to patients, colleagues and society American Board of Internal Medicine (CPA Bulletin, 2002)

8 Leadership The process through which an individual attempts to intentionally influence another individual or a group in order to accomplish a goal. Locus of leadership: a person Focus of leadership: other individual or groups Most critical element: influence Shortell and Kaluzny, 1997

9 Leadership traits Personal: integrity, courage, discipline, loyalty, a sense of justice, sacrifice, honor, unselfishness, tact, decisiveness, reliability, moral character & enthusiasm Leadership skills and techniques Intellectual breadth Intellectual depth Resident Leadership Webinar

10 The trouble with attitudes as learning outcomes: When we follow codes of conduct or rules of decorum, we are often just play acting, acting appropriately in outer conduct, irrespective of what is in our hearts. Sherman, 2005 ; cited in Rees, & Knight, Acad Med, 2007

11 The Affective Domain of Learning (Krathwohl, et al., 1960) Responding Valuing Organization Characterization Receiving Compliance Identification Internalization Consistency

12 Practical tools to teach leadership & professionalism Workplace 1.Clinical environment (Accreditation Council for Graduate Medical Education, 2004) Approaches to teach Clinical (experiential) teaching-learning – Actual clinical work – Bedside teaching – Rounds – Endorsements – Audits Teaching : facilitating, explaining, clarifying, closing consciously by the experiential learning cycle, inculcating, indoctrination, role modelling, and values clarification

13 Practical tools to teach leadership & professionalism Workplace 2.Classrooms and other related settings (Accreditation Council for Graduate Medical Education, 2004) Approaches to teach 1.Lectures 2.Simulations 3.Cooperative and team learning 4.Independent study 5.Discussions and seminars Teaching : facilitating, explaining, clarifying, closing consciously by the experiential learning cycle, inculcating, indoctrination, role modelling, and values clarification

14 The experiential learning cycle (Kolb, 1984) Concrete Experience (Affective) Observations & Reflections (Perceptual) Formation of abstract Concepts & generalizations (Symbolic) Testing implications of concepts in new situations (Behavioral)

15 The Ob-Gyn resident’s teaching- learning milieu

16 Values clarification (Raths, 1960) 1. Choosing: Asking residents about the choices they made in given circumstances 2. Prizing : asking residents if they are satisfied with their choices 3. Acting: asking and observing residents if they can publicly affirm their choices

17 Food chain in Ward X (Sana, 2001) (By order of harassment) Consultant Fellow SR Resident JR Resident Intern Nurse NA Manong Bantay Pasyente Clerks Germs

18 Consultants’ personal attitudes and effects to residents (Morada, 2003) Facilitating learning  Competence  Approachability  Respectability  Confidence  Orderliness  Caring Inhibiting learning  Temper/mood  Inconsistency  Discouraging  Ingratitude  Anxiety  Impulsiveness

19 Assessment (Best and Khan, 1989) The collection of data, organizing them to measure how the learners have achieved the expected levels of competencies as a result of instruction

20 The Nature of Assessment Standard Collecting relevant data Constructing tests Making questionnaires Determining who accomplishes tools When and for how much (content valid) Applying the Standard Measurement Constructs of leadership & professionalism

21 Valid raters of attitudes (Henerson, et al, 1987) RatersWhen appropriate Self When raters understand the questions asked; are aware of the information asked; can answer honestly Others Opposite of above Records When records can be accessed; complete

22 When to assess

23 Types of Assessment used for leadership & professionalism (Norcini & Burch, 2007) Bases of comparison DiagnosticFormativeSummative TimingBefore instructionDuringAfter FrequencyUsually onceFrequentOnce at the end term Usual instruments Role playing, oral examination, OSCE Mini-CEX, DOPS, CbD, MSF OSCE, DOPS, Mini-CEX, Oral Examination Purpose for students To determine readiness To monitor progress To determine final grade Purpose for teachers To guide teachingTo improve teaching To test effectiveness

24 Innovations in clinical evaluations (Norcini & Burch, 2007) Simulated /Controlled 1.Objective Structured Clinical Examination (OSCE) 2.Objective Structured Assessment of Technical Skills (OSATS) 3.OSOE (Oral Examination) 4.OSPE (Practical Examination) Naturalistic / Work place 1.Case based discussion 2.Direct Observation of Procedural Skills (DOPS) 3.Structured Clinical Operative Test (SCOT) 4.Mini-CEX (www.hcat.nhs.uk)www.hcat.nhs.uk Value of feedback The teaching-learning environment The environment for assessment

25 The Ob-Gyn resident’s teaching- learning milieu


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